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Low-energy lateral compression type 1 (LC1) pelvic ring fractures in the middle-aged and elderly affect hospital quality measures and functional outcomes

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to examine hospital quality measures and the long-term functional outcomes associated with lateral compression type 1 [LC1] pelvic ring injuries.

Methods

A query was performed from December 2011 to September 2020 at two institutions within one hospital system for patients with a pelvic fracture diagnosis. Chart review was performed on admitted patients to determine demographic information, medical co-morbidities (to calculate Charlson Co-morbidity Index), in-hospital complications, length of stay [LOS], discharge disposition, and 30-day readmission rates. All patients included were treated nonoperatively. An attempt was made to contact all patients for long-term follow-up to assess current functional status with a Short Musculoskeletal Function Assessment [SMFA].

Results

Two-hundred and eighty-six patients were included, with 172 (65.9%) patients admitted and analyzed with respect to hospital quality measures. Patients admitted were older (83 vs 80 years, p = 0.015) with more medical co-morbidities (p = 0.001) than those discharged from the emergency department. The average LOS was 5.7 ± 3.7 days and 31 (18%) experienced in-hospital complications. The inpatient mortality rate was 1.2%, and the 30-day readmission rate was 8.1%. When comparing admitted patients without concomitant injuries, admitted patients with concomitant injuries, and non-admitted patients, admitted patients with concomitant injuries were found to have more medical co-morbidities (p = 0.001). Forty-three patients were available for long-term follow-up (average 36.6 ± 7.3 months), with an average SMFA score of 29.0 ± 25.7.

Conclusions

Patients admitted for LC1 pelvic fractures are likely to be older with more medical co-morbidities, and up to 1/5th will experience inpatient complications. Although inpatient mortality remains low, this injury pattern can lead to significant functional disability that persists for several years after injury.

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Funding

No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, 301 East 17th Street Suite 1402, New York, NY, 10003, USA

    Nina D. Fisher, Sara J. Solasz, Assefa Tensae, Sanjit R. Konda & Kenneth A. Egol

  2. Department of Orthopedic Surgery, Jamaica Hospital Medical Center, Queens, NY, 11418, USA

    Sanjit R. Konda & Kenneth A. Egol

Authors
  1. Nina D. Fisher
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  2. Sara J. Solasz
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  3. Assefa Tensae
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  4. Sanjit R. Konda
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  5. Kenneth A. Egol
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Nina Fisher, Sara Solasz, and Assefa Tensae. The first draft of the manuscript was written by Nina Fisher, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nina D. Fisher.

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Conflict of interest

Sanjit Konda is a consultant for Stryker. Kenneth Egol is a consultant for Exactech and Synthes, receives royalties from Exactech, Wolters Kluwer, and Slack Inc, receives research support from Synthes and Acumed, and is a paid lecturer for Smith and Nephew. The remaining authors have no relevant financial or non-financial interests to disclose.

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Institutional review board [IRB] approval was obtained for this study.

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Fisher, N.D., Solasz, S.J., Tensae, A. et al. Low-energy lateral compression type 1 (LC1) pelvic ring fractures in the middle-aged and elderly affect hospital quality measures and functional outcomes. Eur J Orthop Surg Traumatol 32, 1379–1384 (2022). https://doi.org/10.1007/s00590-021-03125-7

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  • DOI: https://doi.org/10.1007/s00590-021-03125-7

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